Introduction: First Aid is immediate care given for the purpose of preserving life and minimizing the consequences of injury and illness until help, from trained medical workers is obtained. The likelihood of an injury or accident victim living or dying depends on the timeliness of the aid given. On a global scale, someone dies every 5 seconds as a result of an injury, over 15000 people’s lives are cut short every day and about 5.8 million people die in a year. Survival is greatly increased if bystanders quickly begin applying first aid. Therefore, this study aims to assess the levels of first aid knowledge in secondary pupils at three selected schools in Ndola, Zambia. Methods: An analytical cross sectional study was carried out among pupils at three selected schools in Ndola, Zambia. The data collection tool that was used is a self-administered questionnaire. A two stage sampling method was used. Firstly, a non-probability sampling method was used to select schools. Thereafter, classes and their respective pupils were sampled randomly. A sample size of 376 was used. The study was carried out at Chiluba Secondary School, Lubuto Secondary School and Ndola Skill School. Data was entered and analysed using SPSS version 20, and categorical variables were analysed using chi Square. Results: In this study, majority of the participants had poor knowledge (87.8%), followed by those with average knowledge (6.4%), then those with no knowledge (5.3%) and finally those with good knowledge (0.5%). The mean score was 3.70, the median was 4.00, the mode was 3, the standard deviation was 2.008 and the sum was 1393. It was found that there is an association between levels of first aid knowledge and exposure to first aid information from the media, receiving first aid knowledge from guardians and religion. However, there was no association between levels of first aid knowledge and age, sex, economic status, opinion, being taught first aid at school and being a member of a first aid club. It was found that the factors that influence levels of first aid knowledge include exposure to first aid information from the media and receiving first aid information from guardians. Conclusion: Overall, first aid knowledge amongst secondary school pupils at the three selected school in Ndola Zambia was poor. The mean score was 3.70 which is poor knowledge. It is recommended that first aid training be added to the school curriculum as this will allow a good number of students to be reached over a period of time Furthermore, awareness of first aid should be raised through the media, campaigns and brochures. Finally, it is recommended that like studies be conducted in the future.